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Archived: Carterhatch Domiciliary Care Service Good

The provider of this service changed - see new profile

Inspection Summary

Overall summary & rating


Updated 29 January 2016

This inspection took place over two days, 17 and 18 November 2015. The provider was given 48 hours’ notice because the location provides a domiciliary care service. Carterhatch Domiciliary Care service is provided by the London Borough of Enfield. It provides care and support for around 70 people in their own home. The service works with people living with dementia, learning disabilities, and people with autistic spectrum disorder, older people and people with sensory and physical impairment.

The service was last inspected 14 November 2013 and was meeting all the regulations inspected. There was a registered manager in post. A registered manger is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of law; as does the provider. The registered manager was not present during the inspection.

People were involved in decisions about their care. Where people were unable to have input, best interests meetings and decisions were recorded. Procedures relating to safeguarding people from harm were in place and staff understood what to do and who to report it to if people were at risk of harm. Staff had an understanding of the systems in place to protect people who could not make decisions and followed the legal requirements outlined in the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS).

There were individualised care plans written from the point of view of the people that were supported. Care plans were detailed and provided enough information for staff to support people. We saw that care plans were regularly reviewed and updated as changes occurred.

Risk assessments gave staff detailed guidance and ensured that risks were mitigated against in the least restrictive way. Risk assessments were reviewed and updated regularly.

People received a continuity of care. The provider always tried to ensure that the same care workers looked after people. This promoted good working relationships with people who used the service.

There was a system in place to monitor any missed visits. Missed visits were investigated and followed up. The provider had begun to introduce a new electronic monitoring system to monitor visits.

People were encouraged to have input into their care and the service. The provider ran a quarterly service user forum where people were encouraged to discuss issues and say what they did and did not like about the service they received.

People and relatives said that they were treated with dignity and respect. Staff were able to give examples of how they ensured that they promoted dignity. People were encouraged to be as independent as possible.

Staff received regular, effective supervision and appraisals and attended monthly team meetings. Senior staff completed regular monitoring of care staff via monitoring visits.

We found that there was an open culture that encouraged staff and people to discuss issues and ideas, though team meetings and service user forums. Team leaders supported care staff on a daily basis.

Staff had received training on medicines administration and people were supported to take their medicines safely. Medicines were accurately recorded on medicine administration (MAR) sheets.

Audits were carried out across the service on a monthly and quarterly basis that looked at things like, medicines management, health and safety and quality of care. There was a complaints procedure as well as incident and accident reporting. Where areas for improvement were identified, the registered manager used this as an opportunity for change to improve care for people.

Inspection areas



Updated 29 January 2016

The service was safe. Staff were able to tell us how they could recognise abuse and knew how to report it appropriately.

There were sufficient staff to ensure people's needs were met.

People were supported to have their medicines safely.

Risks for people who used the service were identified and comprehensive risk assessments were in place to ensure known risks were mitigated against.



Updated 29 January 2016

The service was effective. Staff had on-going training to effectively carry out their role. People were supported by staff who reviewed their working practices as staff received regular supervision and appraisal.

Staff understood their responsibilities in relation to meeting the requirements of the Mental Capacity Act 2005 (MCA) and the Depravation of Liberty Safeguards (DOLS).

People’s food and dietary preferences were noted in their care plans.

Peoples healthcare needs were monitored and referrals made when necessary to ensure wellbeing.



Updated 29 January 2016

The service was caring. People were supported and staff understood people’s needs.

People were treated with respect and staff maintained privacy and dignity.

People were supported to make informed decisions about the care they received.



Updated 29 January 2016

The service was responsive. People's care was person centred and planned in response to their needs.

Staff were knowledgeable about individual support needs, their interests and preferences.

Complaints were responded to in an effective and timely manner.

People were encouraged to have full and active lives and be part of the community.



Updated 29 January 2016

The service was well led. There was an open and transparent culture where good practice was identified and encouraged.

Complaints were used as a learning opportunity to improve quality of care.

Audits and surveys were carried out to assess the standard of care.